Hughes K, Aw T C, Kuperan P, Choo M
Department of Community, Occupational, and Family Medicine, National University of Singapore, Singapore.
J Epidemiol Community Health. 1997 Aug;51(4):394-9. doi: 10.1136/jech.51.4.394.
To examine the hypothesis that the higher rates of coronary heart disease (CHD) in Indians (South Asians) compared with Malays and Chinese is at least partly explained by central obesity, insulin resistance, and syndrome X (including possible components).
Cross sectional study of the general population.
Singapore.
Random sample of 961 men and women (Indians, Malays, and Chinese) aged 30 to 69 years.
Fasting serum insulin concentration was correlated directly and strongly with body mass index (BMI), waist-hip ratio (WHR), and abdominal diameter. The fasting insulin concentration was correlated inversely with HDL cholesterol and directly with the fasting triglyceride concentration, blood pressures, plasminogen activator inhibitor 1 (PAI-1), and tissue plasminogen activator (tPA), but it was not correlated with LDL cholesterol, apolipoproteins B and A1, lipoprotein(a), (Lp(a)), fibrinogen, factor VIIc, or prothrombin fragment (F)1 + 2. This indicates that the former but not the latter are part of syndrome X. While Malays had the highest BMI, Indians had a higher WHR (men 0.93 and women 0.84) than Malays (men 0.91 and women 0.82) and Chinese (men 0.91 and women 0.82). In addition, Indians had higher fasting insulin values and more glucose intolerance than Malays and Chinese. Indians had lower HDL cholesterol, and higher PAI-1, tPA, and Lp(a), but not higher LDL cholesterol, fasting triglyceride, blood pressures, fibrinogen, factor VIIc, or prothrombin F1 + 2.
Indians are more prone than Malays or Chinese to central obesity with insulin resistance and glucose intolerance and there are no apparent environmental reasons for this in Singapore. As a consequence, Indians develop some but not all of the features of syndrome X. They also have higher Lp(a) values. All this puts Indians at increased risk of atherosclerosis and thrombosis and must be at least part of the explanation for their higher rates of CHD.
检验以下假设，即印度人（南亚人）相较于马来人和中国人冠心病（CHD）发病率较高，至少部分原因是中心性肥胖、胰岛素抵抗和X综合征（包括可能的组成部分）。
对普通人群的横断面研究。
新加坡。
961名年龄在30至69岁之间的男性和女性（印度人、马来人和中国人）的随机样本。
空腹血清胰岛素浓度与体重指数（BMI）、腰臀比（WHR）和腹径直接且强烈相关。空腹胰岛素浓度与高密度脂蛋白胆固醇呈负相关，与空腹甘油三酯浓度、血压、纤溶酶原激活物抑制剂1（PAI - 1）和组织纤溶酶原激活物（tPA）呈正相关，但与低密度脂蛋白胆固醇、载脂蛋白B和A1、脂蛋白(a) [Lp(a)]、纤维蛋白原、凝血因子VIIc或凝血酶原片段(F)1 + 2无关。这表明前者而非后者是X综合征的一部分。虽然马来人的BMI最高，但印度人的WHR（男性为0.93，女性为0.84）高于马来人（男性为0.91，女性为0.82）和中国人（男性为0.91，女性为0.82）。此外，印度人的空腹胰岛素值更高，葡萄糖耐量异常比马来人和中国人更严重。印度人的高密度脂蛋白胆固醇较低，PAI - 1、tPA和Lp(a)较高，但低密度脂蛋白胆固醇、空腹甘油三酯、血压、纤维蛋白原、凝血因子VIIc或凝血酶原F1 + 2并不更高。
在新加坡，印度人比马来人或中国人更容易出现中心性肥胖并伴有胰岛素抵抗和葡萄糖耐量异常，且不存在明显的环境因素可解释这一现象。因此，印度人出现了X综合征的部分而非全部特征。他们的Lp(a)值也更高。所有这些使得印度人患动脉粥样硬化和血栓形成的风险增加，这必然至少是其冠心病发病率较高原因的一部分。
